Surgical table



June 26,Y 1962 A. COMPER 3,041,121

' SURGICALTABLE INVENTOR. ADRIAN COMPER ATTORNEYS A. COMPER SURGICALTABLE June 26, 1962 4 sheetssheet 2 Filed Sept. 26, 1950 INVENTOR.ADRIAN COMPER l pam( ATTORNEYS June 26, 1962 A. COMPER 3,041,121

SURGICAL TABLE Filed Sept. 26, 1960 4 Sheets-Sheet 3 .R v RE E... oP XS\.,v WM l I l |.I VO 2., E www NG mmv., 1 f 1m www; wil i my. Hm wm n mdm .vhm/ mmm mmm lllwi En b5 m @SWW/7 mi Imml 3 3 i- @i f) BY ,a-za, f11. y '/Lomzc( ATTORNEYS June 26, 1962 A. coMPER 3,041,121

' SURGICAL TABLE l 4 Sheets-Shet 4 Filed Sept. 26, 1960 Fig. |2 4 n INVEN TOR ADR/A N OOMPER A TTOR/VEYS Unit This invention relates tosurgical tables. Reference is made to the copending application of KarlH. Burzlalf, Egon R. Weickgenannt and George E. Martin, Serial No.56,803, filed September 19, 1960, for a detailed discussion of thesurgical table shown herein.

The surgical operating table of my invention is particularly designed togive the surgeon maximum anatomical exposure within the patients woundwith improved and novel means of maintaining his physiologic function bythe anesthesiologist and this is a major object of my invention.

In terms of surgery, the human skeletal structure articulates at thecervical spine, lumbar arch, hip and knee joints. These articulationsdivide the body into the five major regions, the head, the spinal orback section, the pelvic or seat section, the femoral or upper legsection and the lower leg section. For the most advantageous surgicalexposure, these tive major regions should assume a tolerable anatomicalcontour appropriate to the particular procedure, with physiologicdistribution of bodyweight pressure over the table surface. However, itis obviously impossible to conform or fit conventional commercialoperating tables of but four articulated sections with live major bodyregions with body articulations between them. Consequent malpositioningof the patient is frequently inevitable with present commercial surgicaltables. This serious limitation of present tables often restrictsfavorable access to the operative site by the surgical team, especiallywhen managing or controlling physiologic deterioration of the patient.

Another major object of my invention is, therefore, to reduce and forthe most part avoid these restrictions, and for this purpose I haveconceived and evolved an entirely new approach to the problem ofproviding the surgical team with true postural control of the patient.

In enabling this new technique and other techniques wholly new in thissurgical field, the articulating top of the operating table is conformedto the tive major surgical regions of the human anatomy. l have providedan adjustable head section directly under the head of thev patient; aback or spinal section articulating directly under the lumbar arch `andextending to the first thoracic vertebra; a seat or pelvic section withperineal cutout appropriately under the pelvis; a femoral or upper legsection articulating as if from the true hip joints of the patient andextending to the knees thus supporting the thighs; and a lower legsection under the lower legs articulating at the knee joints.

Another object of my invention is, therefore, to provide a table havingfive sections with articulations between each two adjacent sectionswhereby each of the ve major regions of the lbody may be independentlycontrolled and positioned with the objective of achieving Amaximumsurgical or anatomical exposure, minimal physiological disturbance ofthe patient and the most convenient application of new surgicaltechniques which have been developed in recent years.

The differential in the dimensions of the above mentioned five majorbody regions which embrace the short 3,041,121 Patented June 26, 1962.ICC

variation in pelvic lengths between short and tall adult persons andchildren in the teen ages is minimal whereas the differential in boththe spinal and femoral lengths is extensive. To meet this problem, theback and femoral sections on the new operating table are telescopic oradjustable in length. Thus, I have conceived an operating table thatinsures true contour correspondence between the articulations of thetable and the articulations of human anatomy for adult or teen-agepatients of a large range of heights.

My invention, therefore, has for a further object the provision of atable which is adjustable in length in such a manner that persons of alarge range of heights may be accommodated by changing the points ofarticulation of the table with relation to the four major points ofarticulation of the skeletal structure.

Still another object of my invention is to provide a table having aplurality of sections at least one of the sections being capable ofadjustment in length.

The invention initiates or makes possible new techniques for the care ofthe patient at operation. Due to the unique construction of the table ofmy invention, these techniques are available without changing theoriginal position of the operating site. Hypotension induced by surgeryand anesthesia may now be controlled in many cases by the simpleexpedient of elevating the lower eX- tre'mities and V.allowing venousgravity return to the heart. This may be done without placing the entiretable in Trendclenburg position. The operative site .and the otherorgans superior to it may remain in their original position instead ofbeing shifted in a steep downward tilt, thus disturbing the surgicalteam with the incidental movement of the table and the need forrefocusing the surgical light.

My invention, therefore, contemplates a table construction comprisingfive sections each of which is controlled, either manually or by power,independently of the other, thereby enabling the elevation of thefemoral and leg sections and allowing venous gravity to the heartwithout placing the entire table in Trendelen'burg position.

Another and important object owing from my invention is the fact that,by the use of live sections articulated in the manner set forth hereinand supported from a central seat or pelvic section in many cases theTrendelenburg position can be avoided with its consequent change in theposition of the operative site merely by swinging the femoral and legrest sections upward about the articulation Vbetween ,the pelvic andfemoral sections.

Elevation of the lower extremities at the hip joint is most desirable inmany situations. Venous vstasis in the legs may be reduced by theirelevation during the operation. Such elevation likewise reduces the'amount of abdominal muscular tension and may reduce the total amount ofrelaxant ding needed. Such elevation would be helpful during all typesof pelvic and abdominal laparotomies. Moreover, hypotension induced bythe rapidchange from lithotomy position to the flat supine may 1n manycases be prevented or at least reduced by elevation of the femoral .andleg rest section and then gradual reduction in the height of the legs bypivoting the femoral section of the table about the pvot between thefemoral section and the pelvic section.

Another object of my invention is to provide a table having fivearticulated sections corresponding to the five major articulations ofthe body with the control of the five sections being, when desired, suchthat the femoral and leg sections may be raised about the posterior edgeof the pelvic section without elevating the spinal section so that theoperative site in pelvic and abdominal laparotomies remains stationarywhile the legs are elevated about the hip joint as an axis to reduceabdominal muscular tension,

Sudden changes in position such as occur in the operation ofabdominoperineal resection are frequently accompanied by hypotension.This table is uniquely suited to this situation in that adjustment ofthe patient from supine to lithotomy position may be made without havingto move the patient to the foot-end of the table during the operation.

Still 'another object of the invention is to provide a table in whichmovement of the patient on the table during an operation is minimized,this fact being particularly important in abdominoperineal resectionswhere movement of the patient on the table frequently causeshypotension.

Drainage of the tracheobronchial tree during abdominal laparotomies isfacilitated by lowering of the back and head section of the tablewithout disturbing the abdominal site of operation.

Additionally the invention has for an object the lowering or raising ofthe back and head section without moving the pelvic section anddisturbing the operative lsite as, for example, during abdominallaparotomies or in placing the patient in the Kraske position. When inthe Kraske position excessive pooling of blood in the upper extremity ofthe body may be prevented by elevation of the spinal vsection of thetable which articulates at the lumbar arch.

lMalposition of the patient on the table reflects in an adverse mannerupon the physiology of respiration and circulation. In addition, theremay be nerve injuries to the patient. The five sections of the tableallow for separate adjustments in the critical areas without the usualshifting of the patient upon the table. Back sprain, which so frequentlyaccompanies the relaxed supine position, is easily mitigated by simpleflexion of fthe table in the lumbar area with elevation of the legs fromthe hip joint.

My invention, therefore, further contemplates a table of ve sectionsarticulated in a manner corresponding to the articulations of the bodywith two sections of the table being adjustable in length to accommodatepatients of a range of heights, this adjustment together with thelocations of the articulations minimizing malpositioning of the patientand shifting the patient on the table thereby minimizing nerve injuriesto the patient and back sprains.

Other objects and advantages of this invention will be particularly setforth in the claims and will be apparent from the following description,when taken in connection with the accompanying drawings, in which:

FIG. 1 is a top plan view of a iive section table in which the inventionof this application is incorporated;

FIG. -2 is a side elevation thereof;

FIG. 3 is a schematic view showing the tive sections of the table andindicating the articulation joints between them;

FIG. 4 is a schematic view similar to FIG. 3 showing the spinal sectionand the femoral section, telescopically shifted `so as to increase thelength of the table to accommodate persons of larger stature;

FIG. 5 is a sectional view taken substantially on the line 5-5 of FIG. 1in the direction indicated by the arrows;

FIG. 6 is a View, partly in section, looking at the Ibottom of the tableand indicating how a part of the -femoral section may be telescopicallyshifted and located as desired with respect to another part, showing howthe telescopically movable part may be removed from the other part andshowing how the leg rest section may be removed from and locked withrespect to the telescopically movable femoral part;

IFIG. 7 is a view partly in section showing the head end of lthe spinalsection;

FIG; ISlis a top plan view of the head rest section; and

FIGS. 9 to 14 inclusive, diagrammatically illustrate 4 some of the verymany positions into which the table may be swung and the sectionsarticulated.

This application is related to the table more fully disclosed inapplication Serial No. 56,803, tiled September 19, 1960, and is directedbroadly to the concept of a ve 'section table having articulationsconforming anatomically to the four major articulations of the humanbody; the adjustability of the spinal and femoral sections to enable thetable to be adjusted in length to fit most teenagers and adults; theremovability of some of the sections and parts of the sections to adaptthe table to certain surgical procedures; and the use of a perinealcutout located as shown so that the patient does not have to be shiftedduring perineal procedures. Other applications presently to be ledrelate to specific mechanisms and constructions adapted to carry out theabove broad concepts.

The surgical table of this invention comprises a table having a t-ablesurface, generally indicated by the numeral 31, for the reception of thepatient. The metal table surface is adapted to receive one or morecushions (not shown) for the comfort of the patient. The table includesa base 32 from which the ltable surface is supported; pump and motorhousing, generally indicated by the numeral 33; a control box, generallyindicated by the numeral 34, which houses the valves for actuating thevarious hydraulic mechanisms; and a plurality of control handles 36, inthis case five, for separately controlling each of the operations ofraising and lowering the various sections with respect to each other,raising `and lowering the table surface 31 as a whole and laterally andlongitudinally tilting the table. In FIGS. 9 to y14 I have illustrateddiagrammatically a few of the more important positions, from a surgicalstandpoint, in which the patient -may be placed.

The base 32 is mounted on four casters 37 which are provided withlocking means (not shown) to hold the casters against movement when thetable is in use, as lshown and particularly described in Karl iH.Burzlal application Serial No. 777,870 filed December 3, 1958.

A pedestal or support column, generally indicated by the numeral 38, ismounted on the base 32 and supports the table or table surface 31. Thetable comprises tive sections a headrest section 39, a spinal or backsection 41--41 (iFIGS. 3 and 4), a pelvic or seat section 42, a femoralsection 43--43 (FIGS. 3 and 4), and a foot or leg rest section 44. Theheadrest section 39 is manually operated, as presently will appear, thespinal section is operated by a hydraulic piston and cylinder assembly,generally indicated by the numeral 46, and the femoral section 43 isoperated by a hydraulic piston and cylinder assembly indicated by thenumeral 47.

'Referring now to FIG. 3 the table 31 is raised and lowered by `ahydraulic piston `and cylinder assembly, not shown herein but shown anddescribed in the above mentioned application. Lateral tilt of the tableabout a longitudinal axis is `accomplished by a cylinder and a pistonassembly, generally indicated by the numeral 49. Movement of the tableto Trendelenburg (FIG. 9) or reverse Trendelenburg (FIG. 1l) positions,that is, pivoting the table about `a horizontal transverse axis, isaccomplished by a piston and cylinder assembly generally indicated bythe numeral 51.

The primary functions of the table are power operated and controlled andthe hydraulic cylinders above mentioned are fed with oil under pressurepursuant to actuation of the control handles 36 to actuate the tablesections in accordance with the necessities of the surgical operationlbeing performed all as fully described in application Serial No.56,803, filed September 19, 1960.

Referring to FIG. 5 depending below and integral with the pelvic sectionof the table top, is a bifurcated bracket or boss 216 which is connectedto the upper end of a piston rod 217 secured to the piston of theTrendelenburg cylinder 51 by a universal joint 218. A ful1 descriptionof the Trendelenburg cylinder and its connecting parts is given inapplication Serial No. 56,803, filed September 19, 1960.

Referring now to FIGS. l and 2, the table includes side rails 261, 262and 263 on each side of the table. The side rails are rigidly secured tothe various sections by means indicated at 264 having spacers 265 (FIG.5) mounted thereon. These side rails are for the purpose of adjustablyholding clamps for arm rests, leg rests, or stirrups, an anestheticscreen and other removable accessories with which the table may beequipped. Between the pelvic section and the spinal section, these siderails are overlapped and former with openings to receive 'hinge pins 266on opposite sides of the table.

Depending from the pelvic section 42 (FIG. 5) are a pair of bosses 291which have a cutout 292 between them. A pair of support plates 293 arefixed by means of a plurality of screws 294 threaded into the bosses andpass through the plates 293. lCarried at the lower end of the femoralcylinder 47 is a pair of pivot pins 296 which are supported in thebottom of the cylinder and extend outwardly through apertures 297 in theplates 293, The femoral cylinder 47 is free to swing about the axis ofthe pivot pins 296.

The femoral cylinder has a piston mounted therein to either side ofwhich oil may be'adrnitted. Simultaneously with the application of oilto one side of the piston, oil is exhausted back to a sump from theother side thereof. A piston rod 298 is secured to the piston (FIG. 5)and is pivoted to .a boss depending from the lower side of the femoralsection 43. Part of the mechanism for articulating the femoral sectionis shown in FIG. 5. It is unnecessary to describe it any further hereinsince it is disclosed in application Serial No, 56,803, filed September19, 1960, and more fully disclosed `and claimed in an application iiledin the name of Egon Weickgenannt, Serial No. 58,443, filed September 26,1960.

Referring now to FIG. l (see .also FIGS. 3 and 4) the pelvic section haswhat is known in the art as a perineal cutout 331. When the table is tobe used for perineal operations, the femoral section must be moved to anoutof-the-way position so that the surgeon is 'able to be seated closeto the perineal cutout. For this reason, the compound movement of thefemoral section, `as described in the above mentioned application, isnecessary.

As shown in FIG. `6 which is a sectional view of the underside of thefemoral and leg rest table sections, the leg rest section 44 isremovable from the femoral section 43. For this purpose the femoralsection has an yadapter 351 secured thereto by screws on each side ofthe table. Each adapter has a track or ways 352 therein for thereception of a vslide member 353 mounted on the leg rest Vsection 44.The slide member 353 on each side of the table has a nger piece 356which is pivoted at 354 by which'the inger piece may be swung about thepivot 354. The end of the linger piece has a locking pin 357 pivotedthereto which lits into a bore 358 formed in the adapter 351 end of thefemoral section. A spring 359 normally holds the slide member in theposition of the parts shown in FIG. 6.

When the foot section'is to be removed, the finger pieces 356 on eachside of the table are pressed inward against the action of springs`359to withdraw locking pins 357 from the bores 358. The slide members 353may then be moved to the right, as viewed in FIG. 6, in the ways 352 andthe foot section slid olf the end of the femoral section. When replacingthe foot section, the opposite of this operation is performed.

In most adults, the difference in their heights primarily occurs intheir legs and in their spinal or back sections. For this reason theback or spinal section 41 and the femoral section 43 are made adjustablein length. The means for adjustment of the length of these two sectionsis the same so that 'a description of one will suftice;

In FIG. 3 the fixed spinal section has been indicated by -the numeral 41while the movable spinal section has been indicated by the numeral 41.The spinal cylinder 46 is pivoted to the xed section 41. Similarly thefixed femoral section has been indicated by the numeral 43 and themovable femoral section by the numeral 43. The femoral hydrauliccylinder 47 is pivoted to the fixed femoral section 43'.

The adjustability of the spinal and femoral sections is illustrated inFIG. 6. The xed femoral section 43 is shown at the left of FIG. 6. Toenable this adjustability and removability of the adjustable section 43,the Iunderside of the fixed `section 43 is provided with a track or ways360 on each side thereof. One side of each of the ways has a pluralityof, in this case five, openings or bores 362 for the reception oflocking pins 363. Rollers 364 are rotatably mounted on pins 366 suitablyfixed to the movable femoral part 43.

The locking pin 363 is normally pressed toward locking relation with oneof the bores 362 by a spring 370 mounted in a recess which seats in apart of the casting and presses against a snap ring 365 mounted in agroove formed in the locking pin. A set screw 370" enables adjustment ofthe locking pin 363. A fitting 367 is secured to the locking pin andreceives an eccentric pin 368. The eccentric pin is eccentricallysecured to a rotatable member 369 mounted on a shaft 371 which has afiat side. A bearing member 372 is located in a bore formed in a wall374 formed on the underside of the removable section 43. The bearingmember 372 is fixed and the shaft rotates within it. A set screw 373extending through the casting holds the bearing member against movementlongitudinally and rotationally in the bore. The shaft 371 has a atextension 376 which is secured in any suitable manner to a hand releasepiece 377. Upon loosening and resetting the set screw 370', hand releasepiece 377 may be set as desired.

It will now be understood that upon moving the hand release piece, theshaft 3711 will be rotated and the eccentric pin 361 will rotate toreciprocate the fitting 367. This action will withdraw the locking pin363 against the action of spring 370 from the particular bore 362 inwhich it is seated. The movable section 43 may then be shifted withrelation to the fixed section to the desired posias diagrammaticallyillustrated in FIG. 4. In FIG. 3 the movable spinal section 41 and themovable femoral section 43 have been superimposed over the fixedsections 41' and 43 respectively. In FIG. 4 the spinal and femoralsections have been extended their maximum distance. As will be apparentfrom FIG. 6, the movable femoral section y43 may 'be completely removedfrom the fixed section 43. Similarly the movable spinal section 41 maybe completely removed from the fixed spinal section 41. A stop pin 375and cutout stop plate 361 (FIG. 6) prevent unintended removal whenextending the section. In order to remove the section, the section hasto be lightly'lifted when the stop pin touches the stop plate.

In the performance of certain operations the upper legs must be raisedWhile the lower legs may be allowed to retain their original position ormay be raised if desired. Such a position is illustrated in FIG. 13. Asimilar raising of the upper legs may be accomplished merely byactivating the femoral cylinder to allow venous gravity return to theheart. This avoids the necessity of placing the entire table inTrendelenburg and interrupting an operation on the upper part of thebody. Other surgical situations exist where the upper legs must beraised and the lower legs lowered.

The combination of the particular articulation of the femoral sectionwith respect to the pelvic section and the length adjustability of thefemoral section enables Ythe positioning of the parts 43 and 44 of FIG.13 without causing pressure on any part of the legs. By adjustmg thelength of the femoral section to fit the patient so that the jointbetween the femoral section and the leg rest section lies directly belowthe knee Ijoint,`the femoral section may be raised without changing therelationship of the knee joint with respect to the joint in the table.This is so because the femoral section swings about an axis above thetable surface as described in the above mentioned application. Caseshave been known, when using present surgical tables and failure of thesurgical team to use adequate additional padding, where the legs of thepatient had to be amputated due to long exposure of the lower legs topressure.

The head rest section 39 is removable from the spinal section 41 as willpresently appear. Thus the head rest section 39, the removable spinalsection 41, the removable leg rest section 44 and the removable femoralseetion 43 may all be removed from the table leaving only the seat orpelvic section 42 and the short sections 41 and 43 articulated withrespect to the pelvic sections. All the actuating elements previousl;ldescribed are operatively connected to these sections.

Referring now to FIG. 2, the head rest section 39 has been shown. Thehead rest 39 may be swung about a pivot 386 secured to an arm 387 theend of which is split at 388. The head rest assembly may pivot about apivot 389 and Ibe locked in any desired adjusted position. For thispurpose the arm 387 is split at 391 and a hand operated clamp 392 opensand closes the gaps at 388 and 391, to release the head rest assembly toenable it to be shifted and locked in a desired adjusted position. Thehead rest, for example, may be shifted so that it hangs downward normalto the plane of spinal section 41 or at its other extreme rests on thespinal section either normal theerto or at a tilt angle. The single handlever locks both clamps 388 and 391. The specific manner in which thisis accomplished is old and well known and per se does not constitutepart of the present invention.

As previously mentioned the head rest section is removable from thespinal section 41. This is illustrated in FIG. 8. For this purposeattached to the arm 387 is a connecting piece `401 which has a bracket402 secured thereto. The bracket 402 has two forks 403 rigidly securedthereto which lt into bores 404 formed in the underside of the spinalsection 41. The forks are locked in the bores by hand clamps 406 theends of which engage the forks. `Within limits the head rest assemblymay be shifted toward and away from the spinal section 41. The head restassembly has side extensions 407 which carry side rails 4018. The siderails are for the purpose of supporting an anesthetic screen assemblyand for this reason are movable with the head rest.

The leg rest section 44 is releasably locked with respect to the movablepart 43 of the femoral section. This locking means, located on theunderside of the leg rest section, comprises a multiplicity of discs 410and 409 only two of which have been shown. The discs 410 are splined toa casing 411 while the discs 409 are splined to a shaft or rod 41.2 asshown at 413.

A hand release lever 414 extends below the end of the leg rest section,is supported in any suitable manner and has adjustable stops 416. Theinner end of the lever 414 is fitted to a cam 417 which has two flatspots 4118 and 419. The cam 417 actuates a pair of pushrods 421 and 422through rollers riding on the cams. The pushrods include threadedmembers 423 having nuts 424 thereon threaded into sockets in thepushrods. A U- shaped mounting 425 for slidably receiving the pushrodsis supported fromthe leg rest section. A spring 426 coiled in a cage 427carried by the leg rest section is extended and tied to the hand releaselever 414 as shown at 428.V

In the solid line position of the release lever 414, the cam is rotatedfrom the position of FIG. 6 and the pressure of the spring and theaction of the cam is such as to exert pressure on pressure members 430rigidly connected to the threaded members 423. The force exerted 8 onthe pressure members 430 may be varied by adjusting the nuts 424.

The casing 411 is fixed to the leg rest section and rotates with itabout the axis of the shaft 412. The shaft 412 is fixed to the slidemember 353. When pressure is applied on the outer plate 410, the discsare free to shift and apply pressure between the discs 410 and 409 andsince the shaft 41.2 is iixed in position, the casing 411 is rigidlyheld and the leg rest is locked in the desired adjusted position withrespect to the movable part 43 of the femoral section.

To release the leg rest section the hand release lever is shifted to thedotted line position which frees the discs 410 and 4019k from frictionalengagement and permits rotation of the leg rest section about the axisof the shafts 412. When the leg rest section reaches the desiredposition o-f adjustment, the hand release lever is released and thespring 426 snaps the cam 417 to locking position to apply pressure onthe discs and lock the leg rest in the adjusted position. The action istherefore a self-locking one. Moreover, because the locking mechanism isapproximately on the axis of articulation, the leg rest section may berotated through an arc of or more. Angular locked positions of the legrest with respect to the movable part 43 of the femoral section areshown in FIGS. 13 and 14.

Adults and teen-agers vary greatly in height but most of this variationoccurs in the legs and the upper trunk. Variations in Alengths from theneck upward and from the knees downward are unimportant as these are theend sections of the table and in any event the head rest section can be`adjusted with respect to the spinal section as indicated in FIGS. 7 and8. The variation in length of the pelvic section in adults andteen-agers is not great. Therefore, by adjusting the length of thespinal section and the femoral section the table may be made to iit mostadults and teen-agers. By adjusting these -sections and adjusting theheadrest with respect to the femoral section, the articulation ybetweenthe head rest and the spinal section may be located directly under theneck; the length of the spinal `section may be adjusted to conform tothe length of the back of the patient; the articulation of thel spinalsection with respect to the pelvic section will be substantially underthe lumbar arch; the articulation between the pelvic section and thefemoral section will be substantially under the hip joint; and thefemoral section may be adjusted in length to conform to the length ofthe upper legs of the patient so that the articulation between the legrest section and the femoral section is directly under the knee joint.

Moreover, Ias previously mentioned and more fully described in the abovementioned applications, upon removal of the leg rest section and theremovable part of the femoral section, the remainder of the femoralsection may be swung downward and out of the way to enable access to theperineal cutout 331.

In FIGS. 9 to 14 inclusive I have shown a few representative positionsin which the table of my invention may be placed but it will beappreciated that many more positions of the table sections are possible.FIG. 9 shows the Trendelenburg position for Venous return to the heart.The anesthetist places the patient in this position when necessaryduring surgery. However, with the table of my invention because it can-be articulated at the pelvis, venous return can usually be accomplishedwith the table, for example in the position of FIG. l0, merely byswinging the femoral and leg rest sections about the articulationbetween the pelvic and femoral sections.

The position of the table sections shown in FIG. 11 is known as thereverse Trendelenburg position. This position of the table sections isemployed in, for example, thyroidectomy and in gall bladder surgery.

The position of the table sections shown n FIG. 12 is used in kidney andchest surgery. The position of the "able (FIG. 13) sections (FIG. 13)either with or without the headrest removed, is employed in neurosurgeryand in cranitomy. The position shown in FIG. 14 either with the headrest section as shown or placed at right ingles to and on the top of thespinal section is employed in culdoscopic and sigmoidoscopicexaminations and operations.

It will be appreciated that in all the positions of the table sectionsshown and many others, the table may be adjusted and tailored to t thepatient with the attendant minimizing of pressure points and shockduring surgery. While I have shown and described the preferred form ofmechanism of my invention it will be apparent that various modificationsand changes may be made therein, particularly in lthe form and relationof parts, without departing from the spirit of my invention as set forthin the appended claims.

I claim:

l. A surgical table or the like comprising, in combination, at leastfive table sections, said table sections including a head section, aspinal section, a pelvic section, a femoral section and a leg section,said sections being articulated with respect to each other and being ofsuch length as to accommodate a man of average height so that thearticulation between the head section and the spinal section is locatedsubstantially at the neck, the articulation between the spinal sectionand the pelvic section is located substantially at the lumbar arch, thearticulation between the pelvic section and the femoral section islocated adjacent the hip joint and the articulation between the femoralsection and the leg section is located substantially at the knee jointsand means for articulating said sections.

2. A surgical table in accordance with claim 1 in which at least one ofsaid sections is adjustable in length.

3. A surgical table in accordance with claim 1 in which the spinalsection has at least two parts and means are provided for telescopingsaid parts to vary the length of the spinal section.

4. A surgical table in accordance with claim 1 in which the femoralsection has at least two parts and means are provided for telescopingsaid parts to vary the length of the femoral section.

5. A surgical table in accordance with claim 1 in which the spinalsection and the femoral section each have at least two parts and meansare provided for telescoping said parts to vary the lengths of thespinal section and the femoral section.

6. A surgical table or the like comprising, in combination, at leastlive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said connections providing means for `articulating saidtable sections with respect to each other and a perineal cutout in saidpelvic section.

7. A surgical table or the like comprising, in combination, at leastfive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said connections providing means for articulating saidtable sections with respect to each other, a perineal cutout in saidpelvic section and means in said table sections for changing thelocation of at least two of said points of articulation with respect tosaid pelvic section.

8. A surgical table or the like comprising, in combination, at leastlive table sections, said table sections including a head section, aspinal section, a pelvic section, a femoral section and a leg section,said sections being articulated with respect to each other and being ofsuch length as to accommodate a man of average height so that thearticulation between the head section and the spinal section is locatedsubstantially at the neck, the articulation between the spinal sectionand the pelvic section is located substantially at the lumbar arch, thearticulation between the pelvic section and the femoral section Y l@ islocated adjacent the hip joint, the articulation between the femoralsection and the leg section is located substantially at the knee joints,a perineal cutout in said pelvic section and means for adjusting thelength of said spinal section and said femoral section to accommodatethe table to persons of heights varying from the average and means forarticulating said sections.

9. A surgical table or the like comprising, in combination, a pluralityof table sections including a head rest section removably attached toone of the other sections, side rails for an anesthetic screen rigidlyattached only to said head rest section, said head rest section beingadjustable toward and away from the section to which it is attached sothat simultaneously with such adjustment the anesthetic screen isautomatically adjusted.

10. A surgical table or the like comprising, in combination, at leastfive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said connections providing means for articulating saidtable sections with respect to each other and means for increasing ordecreasing the length of at least one of said sections.

ll. A surgical table or the like comprising, in combination, at leastlive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said connections providing means for articulating saidtable sections with respect to each other and said pelvic section beingbetween said spinal section and said femoral section.

12. A surgical table or the like comprising, in combination, at least vetable sections connected in series, said table sections including a headsection, a spinal section, a pelvic section, a femoral section and a legsection, said spinal section having at least two parts, means fortelescoping said parts to vary the length of the spinal section, meansfor articulating each of said sections with respect to its adjacentsection and means for tilting at least some of said sections includingsaid pelvic section.

13. A surgical table or the like comprising, in combination, at leasttive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said femoral section having at least two parts, means fortelescoping said parts to Vary the length of the femoral section, meansfor articulating each of said sections with respect to its adjacentsection and means for tilting at least some of said sections includingsaid pelvic section.

14. A surgical table or the like comprising, in combination, at leastfive table sections connected in series, said table sections including ahead section, a spinal section, a pelvic section, a femoral section anda leg section, said spinal section and said femoral section each havingat least two parts, means for telescoping said parts to vary the lengthof the spinal and the femoral sections, means for articlulating each ofsaid sections with respect to its adjacent section and means for tiltingat least some of said sections including said pelvic section.

15. A surgical table or the like comprising, in combination, a pelvicsection, a spinal section, articulated with respect to said pelvicsection on one side thereof, a femoral section articulated with respectto said pelvic section on the other side thereof, means for raising andlowering the spinal section and the femoral section independently ofeach other without changing the position of the pelvic section, a headrest section articulated with respect to said spinal section, a leg restsection articulated with respect to said femoral section, said head restsection and said leg rest section being removable from the sections withrespect to which they are articulated.

16. A surgical table or the like comprising, in combination, a pelvicsection, a spinal section, articulated with respect to said pelvicsection on one side thereof, a femoral -section articulated with respectto said pelvic section on References Cited in the le of this patentUNITED STATES PATENTS 7,789 Shoerrberger Nov. 19, 1850 12 Glasin May 17,1949 Buckley Oct. 16, 1951 Nimmo Dec. 23, 1952 Davis et al Jan. 25, 1955Fullwoodet al. June 4, 1957 McDonald Mar. 25, 1958 McDonald July 21,1959 FOREIGN PATENTS Germany Apr. 9, 1959

